What Is SIDS? How To Reduce The Risks

Baby Sleeping in Cot With Dummy

About SIDS and How to Reduce The Risk

SIDS (sudden infant death syndrome) is a major concern for any new parent and there are several steps you should take to reduce the chance of SIDS. SIDS is the unexplained death of a seemingly healthy infant usually during the evening with no signs of suffering. In spite of extensive research SIDS is the leading cause of death for infants under the age of 1 year old. There is no known explanation for SIDS, although there are many recommendations and theories as to why it may occur. New parents should be aware of all of the risk factors for SIDS and many of them involve regulating the sleep environment of their babies and ensuring that it is as safe as possible.

What Are The Risk Factors?

There is no single risk factor for SIDS but there are several that parents should be aware of. Certain racial groups such as Native Americans have a higher incidence of SIDS, and there is a higher incidence during cold weather. There are no known causes, but SIDS is thought to result from an environmental trigger at a particularly vulnerable age, and most cases occur between the ages of 2 to 4 months. In the United States alone somewhere near 4,000 infants die every year from SIDS, so it is a serious issue for any parent to consider throughout the world. The rate of SIDS has declined over 50% since 1990 in the U.S., likely due to education and awareness of the syndrome. Some of the known risk factors for SIDS are described below, many of which are avoidable.

Stomach sleeping and rebreathing are two major SIDS risk factors

Infants should never be placed to sleep on their stomach, even though they may find the position comfortable or preferable. Several studies have found a higher rate of SIDS for infants that were put to sleep on their stomachs. There is no specifically known reason as to why the rates are higher for these babies, but some researchers hypothesize that the position puts pressure on the baby’s jaw which can reduce the airway and cause suffocation. Stomach positions should never be used for napping either; however for soothing and playing under continual supervision a stomach position is fine.

There is also the concern that stomach sleeping causes “rebreathing” or inhaling exhaled air that is depleted of oxygen. Rebreathing is thought to occur when the infant is placed in close proximity to toys or other objects or pillows near the face that can block airways. It is thought that a soft toy can block the mouth and trap air, causing oxygen deprivation. As a result toys should never be placed near a baby’s head in a crib. There are some experts who believe that some babies have a defect in the arcuate nucleus, which is a part of the brain that wakes the baby up when he or she is deprived of oxygen. If there is a defect in this part of the brain the baby would not wake up and cry when oxygen deprived and parents would not be alerted, putting the baby at a greater risk of SIDS.

More SIDS Risk Factors and Theories

There are several risk factors and theories for sudden infant death syndrome which can help to explain the incidence of the syndrome and help parents reduce the risk of SIDS for their children. The “Back to Sleep” public awareness campaign in the United States was intended to teach parents to put their babies to sleep only on their backs, but there are unique considerations to take into account with this strategy.

After the campaign SIDS dropped over 50%

The idea that stomach sleeping may have been a major risk factor for SIDS seemed to be true after the “Back to Sleep” campaign resulted in over a 50% decrease in SIDS for infants in the United States, even though SIDS remains the leading cause of death for young infants. So there is evidence that back sleeping is definitely safer, but parents have had some concerns with back sleeping.


Positional plagiocephaly may be a concern

Parents should be concerned about positional plagiocephaly, or the development of a flat spot on the back of your baby’s head as the result of extensive back sleeping. This can be avoided however but it is treatable by changing your baby’s position often while he or she is sleeping and giving your baby “tummy time” while awake. If positional plagiocephaly is a concern for you, discuss how to reduce it with your baby’s doctor.

Side sleeping is not recommended

Side sleeping is also not recommended along with stomach sleeping because babies can roll over on their stomachs when in a side sleeping position. Even though your baby may strongly prefer stomach or side sleeping the safest thing to do is to place them on their backs until they are able to roll over on their own consistently.

At the age of four to seven months you can let your baby pick a sleeping position

Around the age of four to seven months your baby may be able to roll over without any issues. Once that happens you can let him pick his own sleeping position with the approval of your pediatrician, but make sure that your baby is comfortable and easily able to roll over before you do this.

Until they reach the age where they are able to roll over you should always use a back sleeping position. There are several other preventative measures that parents should take to reduce the chance of SIDS including the use of pacifiers and breastfeeding, and it is unclear how either of these measures work although they have shown to be effective.

Room temperature, bedding and clothing are also important considerations, and new parents should have an extensive education on the types of bedding and other materials that may be risk factors for SIDS, along with following every strategy necessary to reduce the chance of SIDS as much as feasible.

Happy Baby In white towel

Tips for Reducing the Chance of SIDS

The incidence of SIDS worldwide has been reduced through awareness of the risk factors and by parents following recommendations to reduce the chance. Along with putting your infant to sleep on his or her back, you should follow these researched and proven practices to reduce the chance of SIDS.

1. Use a firm mattress without toys or blankets nearby

Put your baby on a firm mattress without blankets, toys, pillows, comforters or other materials that can cause an airway obstruction nearby. Do not use a pillow, couch, soft chair, waterbed or other soft material as a mattress for your baby. Keep all toys away to reduce the chance or rebreathing.

2. Get the recommended immunizations

Studies have shown that babies who have been immunized have up to a 50% reduced chance of SIDS, so you should be sure to get the recommended immunizations, as they can protect against serious illnesses.

3. Don’t smoke when pregnant

Studies have shown that women who smoked while they were pregnant increase the risk of SIDS for their infants by up to three times, and secondhand smoke can increase an infant’s risk of SIDS by two times. It is thought that cigarette smoke can affect the brain and nervous system of the developing child and increase various types of SIDS risks.

4. Get regular prenatal and pediatric care

Be sure that you get regular prenatal checkups as recommended by a normal prenatal care schedule, and get early prenatal care as well. Studies have shown that women who neglect prenatal care are three times more likely to have a low birth weight infant with a five times higher risk of death. Prenatal care is very important so that physicians can spot problems early on and prevent other problems with treatments as needed. Mothers may also need to be educated on unique circumstances with their particular infant. After birth you should be sure that your baby has regular checkups.

5. Breastfeed if you can

If you can breastfeed your baby there are many benefits, but a major benefit is the reduced risk of SIDS. It is not entirely clear how or why breastfeeding reduces the chance of SIDS, but it is thought to be related to how breast milk may be better for the immune system of infants and protect them from infections that can lead to SIDS.

6. Do not allow your baby to sleep in the same bed

There is a higher risk of SIDS for parents that co-sleep with their babies. You can keep your baby in your room in their crib and you can bring her into your bed for nursing or soothing but always return your baby to the crib when it’s time for bed.

7. Use a pacifier to put your baby to sleep

Babies should be put to sleep with a pacifier for their first year, and there have been studies that show a reduced risk of SIDS for babies that use pacifiers. Again the reason is not clear, and you should not force your baby to use a pacifier if she rejects it.

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Jane Cooke - Baby Sleep Expert